Abstract TP112: Association Of Statin Use And Morbidity-mortality Outcomes In Patients With Acute Stroke And Ldl<70mg/dl: Preliminary Findings From Stroke Registry

Abstract

Introduction: Stroke outcomes in patients with LDL levels <70mg/dl and the utility of statins in these settings are uncertain given the scarcity of data. Our study aims to develop a unique registry, prospectively follow patients with CVA and an LDL < 70 (with and without Statin), and study their fatal/nonfatal cardiovascular outcomes over five years. Method: The study includes patients admitted for stroke and LDL <70 between January 2021 and May 2022. Chart review performed from the stroke registry. We compared two groups (A: Patients on statin before admission vs. B: statin naive patients). Result: Among 469 patients admitted for the stroke, 119(25%) patients had LDL <70. 51.3% were on a statin before index admission, and 48.7% were statin naïve. Mean NIHSS was 9.52 in the statin naive group vs 7.39 in patients already on statin. Prevalence of comorbidities were less in group B: DM(45% vs 64%), CHF(7% vs 28%), CAD(14%vs34%), Atrial Fibrillation(8.6% vs 16%), Valvular heart disease(0% vs 6.6%). Incidence of hemorrhagic stroke was higher in Group B(23% vs 8%). Among group B, 53.4%, 20.7% and 25.9% patients had low (0-5), moderate(6-14) and high NIHSS(>14) respectively vs 57.4%, 24.6% and 18% in group A. Mortality was higher in group B in patients admitted with moderate (33.3% vs 13.3%) and severe NIHSS score(18.2% vs 6.7%). Within group B, patients who were started on statin during admission had a lower modified Rankin Scale (mRS) on discharge, compared to patients who were not started on statin(mRS 0 36.6% vs 0%, mRS 4-17.1% vs 29.4%, mRS 5- 9.8% vs 17.6%). Also, mortality was higher in patients not started on statin. Conclusion: Patients who were not on statins had higher incidence of hemorrhagic stroke, worse functional status on discharge, and higher mortality than those who were already on statin. Patients who were started on statin during index admission had better functional status on discharge and lower mortality than patients who were never started on statin. Our study highlights the better outcomes at discharge with statin use in stroke patients with LDL<70. Further studies are required to validate these findings and to determine the protective effects of statins in these patients.